在牙髓学领域,激光已经使用了很长时间,特别是用于优化牙髓灌溉。激光激活灌溉(LAI)技术基于激光在低设置下的光机械效应。它们在肛门内流体中产生特定的空化现象和声流。最近,使用Er:YAG激光的新技术已使用亚消融能量(20mJ,15Hz)和超短脉冲(50µs)。由于光声和光机械效应,这会导致肛门内空化和冲击波。这种现象被称为光子诱导的光声流(PIPS)。PIPS和激光激活灌溉在文献中被描述为激活灌溉剂的革命性和强大的方法;但是,缺乏关于这个主题的系统文献。这篇综述比较了有关Er:YAGLAI和PIPS在牙髓灌溉与其他灌溉方法上的文献。使用一系列与牙髓灌溉相关的关键字在PubMed数据库上进行了文章搜索,包括Er:YAGLAI和PIPS;根据纳入和排除标准选择59篇文章进行审查。没有发现体内研究。在59篇文章中的33篇中,Er:YAGLAI和PIPS优于其他方法。研究设计的种类繁多,包括细菌孵化时间,激光参数,灌溉协议,和使用的灌溉溶液。证据表明,Er:YAGLAI和PIPS在运河消毒以及碎屑和涂抹层去除方面很有前途。然而,研究方法的多样性使得结果不太显著。需要进一步的研究来更好地评估这些技术的效率,尤其是体内研究。
In the field of endodontics, lasers have been used for a long time for the optimization of Endodontic irrigation in particular. The laser-activated irrigation (LAI) technique is based on the photomechanical effects of the lasers at low settings. They create specific cavitation phenomena and acoustic streaming in intracanal fluids. More recently, a new technique with a Er:YAG laser has been used with sub-ablative energy (20 mJ, 15 Hz) and ultra-short pulses (50 µs). This leads to intracanal cavitation and shockwaves as a result of photoacoustic and photomechanical effects. This phenomenon is called photon-induced photoacoustic streaming (PIPS). PIPS and Laser activated irrigation are described in the literature as a revolutionary and powerful method to activate the irrigant; however, systematic literature on this topic is missing. This
review compares the literature on Er:YAG LAI and PIPS on endodontic irrigation with other irrigation methods. An article search was performed on the PubMed database using a series of keywords related to endodontic irrigation, including Er:YAG LAI and PIPS; 59 articles were selected for the
review according to the inclusion and exclusion criteria. No in vivo study was found. The Er:YAG LAI and PIPS outperformed other methods in 33 of the 59 articles. There was a great variety in the study designs including bacterial incubation time, laser parameters, irrigation protocols, and irrigating solution used. The evidence suggests that the Er:YAG LAI and PIPS are promising in canal disinfection as well as debris and smear layer removal. However, the large variety in the study methods makes the results less significant. Further studies are needed to better evaluate the efficiency of these techniques, especially in vivo studies.